Prominent Oncologist’s Death Wish at Age 75

Published in Pawtucket Times, December 12, 2014

Dr. Ezekiel Emanuel, MD, Ph.D., a nationally-recognized oncologist and bioethicist, definitely marches to a different drummer.  While millions of older Americans pop Vitamins and supplements like M&M Candy, regularly exercise at their local gym, religiously jog and carefully watch what they eat to increase their life span, the chair of medical bioethics and health policy at the University of Pennsylvania, says living past the ripe old age of 75 is not on his bucket list.  We would be doing both society and our loved ones a favor by agreeing with this belief, he says.

When I am 75…

Why not age 80 or even 85?  Emanuel admits that his 75th birthday day was just a randomly chosen number, but the year was selected because scientific studies indicate that increases in physical and mental disability occur around this age, as well as a decline in both creativity and productivity.

The renowned 57-year old breast oncologist is at the top of his professional game.  Emanuel has received dozens of awards from organizations such as the National Institutes of Health and the American Cancer Society, including being elected to the Institute of Medicine (IOM) of the National Academy of Science, the Association of American Physicians, and the Royal College of Medicine (UK). Hippocrates Magazine even selected him as Doctor of the Year in Ethics.

Emanuel is a prolific writer, editing 9 books and penning over 200 scientific articles. He is currently a columnist for the New York Times and appears regularly on television shows including Morning Joe and Hardball with Chris Matthews.  .

The prominent physician, is also considered a key designer of the Affordable Care Act (commonly called Obamacare).  At a personal level, he has two well-known brothers, Chicago mayor Rahm Emanuel, former White House chief of staff, and Hollywood agent Ari Emanuel.

With this prominence, Emanuel’s death wish to die at 75, (the year 2032) before the onset of Alzheimer’s disease and other dementias, and decreased physical stamina (it’s harder to walk a quarter of a mile, even to climb 10 stairs) is drawing the ire of critics who charge that he advocates for health care rationing and legalized euthanasia.

But Emanuel claims that these charges are not true.  Setting his death at 75 is just his personal preference, he says, leaving his mortal coil. In his writings and media interviews he notes that setting the age when he hopes to die just drives his daughters and brothers crazy.

Last October, at the BBC Future’s World-Changing Ideas Summit in Manhattan, Emanuel’s prop, a full-page AARP ad from a newspaper, featuring an older couple hiking above a line of text that read, “When the view goes on forever, I feel like I can, too. Go long.”  Reinforcing his point, Emanuel is not buying AARP’s message pushing the positives of living an extended life.  For him, he doesn’t buy it and most definitely, seventy is not the new 50.

Sharing a Death Wish on the Air Ways

On Dec. 7, on CBC Radio Canada’s Sunday Edition, Emanuel, discussed his controversial October 21, 2014 article published in the The Atlantic, “Why I Hope to Die at 75.”  His Sunday interview detailed his unconventional and controversial stance, especially to AARP, the nation’s largest aging advocacy group, and aging organizations who strongly oppose this type of thinking.

Throughout the 28.12 minute interview with Michael Enright, Emanuel, he warns listeners, “Don’t focus on years, and focus on quality.”

“A good life is not just about stacking up the years and living as long as possible. People need to focus on quality of life,” says Emanuel, noting that “Setting an actual date for a good time to die helps you focus on what is important in your life.”

“It is really about what you are doing to contributing and enriching the world.  I want people to stop focusing on just more years, focusing on quality,” he says.

Emanuel says that you need to be realistic on living forever, your body and mind doesn’t  go on forever.  You should just be satisfied with living a complete life, he says.

By age 75, people will have gone through all stages of life, says Emanuel.  As a child you begin to develop skills and figuring out your place in the world. You go to college, raise a family, work to hone your skills and talents. At the later stages of your life you give advice and mentor people, he says, noting that in your mid-seventies, physical deterioration and mental slowing along with loss of creativity, begin to be felt.

During his radio interview, Emanuel claimed he is very active, recently climbing Mount Kilimanjaro with is two nephews, stressing that he is in relatively good health and doesn’t have a terminal illness and has no plans to commit suicide.   As a matter of fact, the physician even condemned physician-assisted suicide and euthanasia, in a 1997 article published in The Atlantic, a policy allowed in the states of Oregon, Vermont and Washington.  His philosophical view of ending one’s life is to allow the body to age naturally, he stresses.

In eighteen years, Emanuel pledges to refuse all medical procedures and treatments, including taking medications such as statins, cholesterol lowing drugs, and antibiotics that could prevent life-threatening illnesses or extend his life.  He notes that his last colonoscopy will be at 65, to screen for cancer.  No more colonoscopies after 75.  And, he’ll only accept palliative care after that milestone age, too.

“I’m not suggesting people kill themselves at 75 but, rather, let nature take its course,” Emanuel says.

How Others See it

Emanuel’s personal preference not to seek medical procedures or to use medications at age 75 that might lead to his death is not the same as physician assisted suicide, says Rev. Christopher M. Mahar, S.T.L., of the Providence Catholic Diocese, noting that this choice has always been respected by the Catholic Church.

“He is not actively choosing to take his life, and as long as he is not rejecting any of the ordinary means necessary for the preservation of life, such as nutrition and hydration, and is not intentionally destroying his body, he is free to decide for himself, says Mahar.

As Emanuel says, there is a downside to aging.  My 88-year-old mother died after a 14 year battle with Alzheimer’s disease.  At age 89, my father, whose quality of life declined over his later years, died suddenly, by having a pulmonary embolism.

For me, 89 is the year I choose to meet my maker, hanging up my spurs.  Yes, I will let nature take its course, but I will most continue to take Vitamins and antibiotics, even my Lisinopril, for high blood pressure.  I will not turn my back on medical procedures or technology that might enhance the quality of my life, even lengthen it.

I agree with the statement of late Actress Betty Davis stated, “Old age ain’t no place for sissies.”   There is no alternatives, you can only hope for nature to ultimately take its course, and it will.  And so, we all are inclined to pick our own magic number.

Herb Weiss, LRI ’12, is a Pawtucket writer who covers aging, health care and medical issues.

Study: Citizens Over Age 50 Not a Drain on Economy

Published in Pawtucket Times, October 10, 2014

Almost one year ago, Oxford Economics in cooperation with AARP released a briefing paper, The Longevity Economy. The national study gave the nation’s largest aging advocacy group the ammunition it needed to dispel the myth that baby boomers and seniors are not a drain on the nation’s economy, rather researchers found that they drivers of the nation’s economic growth. This data will keep businesses, investors and inventors from overlooking the wants and needs of older Americans as they develop new products and business plans.

This week the national analysis was supplemented, detailing the state level contribution of people over 50.

Shattering a Myth

According to Jody Holtzman, AARP’s Senior Vice President Thought Leadership, the nonprofit aging advocacy group commissioned the initial Longevity Economy report from Oxford Economics to challenge society’s and Washington’s misconceptions that people over age 50 are only a drain on the economy. He said, “to the contrary the analysis shows that this population is an important driver of economic growth in key sectors of the United State economy such as technology, healthcare, travel and education.”

Holtzman says the formal economic impact analysis has been conducted, both nationally at the state level can shift the way federal and state policy makers will view the nation’s aging population. “Not only can we “afford” the growing population of older people, we can’t do without them, as they are a key source of economic growth, jobs, salaries, and taxes that benefit people and families of all ages and generations,” he says.

“The economic activity of the Longevity Economy provides employment for nearly 89 million Americans with $3.8 trillion in salary and wages, contributes $1.75 trillion in Federal and state and local taxes annually and is a huge source of charitable giving, contributing nearly $100 billion annually to a variety of causes and concerns – nearly 70% of all charitable donations from individuals,” says Holtzman.

The 19 page study notes that by 2032, it is projected that over age 50 Americans will make up about 52 percent of the US GDP. The average wealth of the households of these individuals is almost three times the size of those headed by people ages 25 to 50.

As to technology, Baby Boomers (ages 50 to 68) are heavy users of the internet and social networking and they spend more time online when compared to either Generation X (ages 34 to 49) and Generation Y (ages 14 to 33) consumers. Boomers average online spending over a three month period amounts to $650 outpacing the two younger generations.

Researchers also found that those over age 50 fill nearly 100 million jobs, generating over $4.5 trillion in wages and salaries.

The Longevity Economy is not a passing phenomenon, observes Holtzman, noting that increased life spans will result in a “consistently large over-50 population even after the Baby Boomer wave has crested.”

Holtzman adds, “The particular wants and needs of the Longevity Economy when it comes to consumer spending, housing, healthcare and employment have dramatic implications for business, society and government.” Not only does the Longevity Economy have a strong, net positive economic impact on the nation’s economy, the nation’s age 50 and over “will also continue to serve as a significant resource and safety net for their parents and children.”

A Snap Shot of Rhode Island

Despite being 36 percent of the state’s population in 2013 (expected to reach 38 percent in 2040), the total economic contribution of the Longevity Economy accounted for 46 percent of Rhode Island’s GDP, or $24 billion, noted by AARP’s release of its state specific analysis. The impact on the state’s GDP was driven by $18 billion in consumer spending by over 50 households.

Rhode Island’s $24 billion Longevity Economy GDP supported 54 percent of the state’s jobs (0.3 million), 47 percent of employee compensation ($14 billion), and 52 percent of state taxes ($2 billion), says the state specific economic analysis,

Also, the state specific dated noted that the greatest number of jobs supported by the Longevity Economy were in health care (88,000), retail trade (47,000) and accommodation & food service (33,000). Overall, people over age 50 make up 34 percent of the state’s workforce. Sixty seven percent of the workers ages 50 to 64 are employed compared to 79 percent ages 25 to 49.

Finally, 11 percent of the state’s older workers (ages 50 to 64) are self-employed entrepreneurs, compared with 7 percent of people ages 25 to 49. Forty four percent of these older workers work in professional occupations, compared to 47 percent of the younger workers.

The [Rhode Island] analysis takes a closer look at something we have known for some time,” said AARP Rhode Island State Director Kathleen Connell. “Rhode Islanders 50-plus are an important driver of our state’s economy,” she says.

Connell says the data complements findings in a paper published recently by the journal PLOS ONE, a group of international researchers at the International Institute of Applied Systems Analysis, the Max Planck Institute and the University of Washington. “It concluded that as retirement approaches and certainly after retirement, leisure time increases. And while there are many who will gear down, relax, travel and devote time to grandchildren (traditional retirement), Baby Boomers – better educated, healthier and with greater access to information than any previous generation of retirees – will have much more time to provide the energy and intellectual capacity, as well as the capital resources to help drive innovation,” she adds.

“With that in mind, AARP partners with the Small Business Administration to support ’encore entrepreneurs’ 50 and older. I agree with SBA Administrator Karen Mills, who says retirees are using their decades of expertise and their contacts to start new businesses and to finally pursue that venture that has been stirring their dreams for all these years,” Connell says.

“So not only do the people who make up the longevity economy represent an economic impact,” Connell added, “they are in a position to be leaders in innovation.”

AARP’s economic data analysis has shattered the age-old myth that a growing older population will ultimately bankrupt the federal and state’s budgets because of the need for increased programs and services for these individuals. Data shows us that America’s oldest generations can be considered the gas that revs the state and nation’s economic engine. Federal and State policy makers need to get this point.

Herb Weiss, LRI ’12, is a Pawtucket-based writer who covers aging, health and medical care issues. He can be reached at hweissri@aol.com.

Movies Not Just For Kids: AARP Picks Its 2013 Faves

Published in the Pawtucket Times, December 27, 2013

May be a little less visible than the Golden Globes or even the Academy Awards, the Washington, D.C.-based AARP, the nation’s largest aging advocacy group joins the two groups, recognizing outstanding writing, acting and film making but also looking at distinct relevance to the age 50 and older audience.

Gravity, 12 Years a Slave and Nebraska are among this year’s Top 10 Movies for Grownups, according to AARP The Magazine. According to the publication’s editors the top 10 list features “thoughtful films with timeless entertainment value and a particular appeal for grownup audiences.” The films are selected by the editors of AARP The Magazine, probably one of the most recognized publications geared to 50 and older Americans and the world’s largest-circulation magazine with more than 35 million readers (sent to AARP members as a membership benefit).

Great Films for Older Audiences

As award season nears, the Golden Globe awards will be announced on January 26, 2014, followed by the Academy Awards on March 2, 2014, AARP The Magazine releases its listing of best films of the year that resonate with a 50 plus audience,” said Bob Love, Editor-in-Chief of AARP The Magazine. “We’ve seen a shift this year in that some of the most successful films at the box office were stories appealing to this mature crowd. There’s been a resurgence of interest in older actors in standout roles and 50+ directors behind the camera—and we are thrilled to see the change!”

Recognizing filmmakers age 50 plus who continue to do innovative risk-taking work, actors and actresses age 50 and over offering increasingly compelling performances, and big-screen explorations of topics that resonate specifically with baby boomers and seniors, AARP The Magazine’s editors selected the following Top 10 Movies for Grownups in 2013 (details from Wikipedia):

12 Years a Slave is a 2013 historical drama and adaptation of the 1853 autobiography by Solomon Northup, a New York State-born free negro who was kidnapped in Washington, D.C. in 1841 and sold into slavery. He worked on plantations in the Louisiana for twelve years before his release. The $20 million budgeted film directed by Steve McQueen with the script written by John Ridley, was filmed in New Orleans. Chiwetel Ejiofor stars as Northup and has been widely praised for his work in this 134 minute feature film. More info: http://www.imdb.com/title/tt2024544/

All Is Lost is a 2013 American survival film written and directed by J.C. Chandor. The 8.5 million budget film stars Robert Redford as a man lost at sea. Redford is the only cast member, and the film has almost no dialogue. According to BBC News, the 100 minute film screened out of competition at the 2013 Cannes Film Festival, noting that having the screening the film received a standing ovation. More info: http://www.imdb.com/title/tt2017038/

Captain Phillips is a 2013 American action thriller film directed by Paul Greengrass and starring Tom Hanks and Barkhad Abdi. The 133 minute film tells how merchant mariner Captain Richard Phillips was taken n hostage by Somali pirates in the Indian Ocean during the Maersk Alabama hijacking in 2009 led by Abduwali Muse. The screenplay by Billy Ray is based upon the book, A Captain’s Duty: Somali Pirates, Navy SEALs, and Dangerous Days at Sea. More info: http://www.imdb.com/title/tt1535109/

Dallas Buyers Club is a 2013 American biographical drama directed by Jean-Marc Vallėe and starring Matthew McConaughey, Jared Leto, Jennifer Garner and Steve Zahn. The 116 minute film is based on the true-life tale of Ron Woodroof, who was the subject of a lengthy 1992 article in The Dallas Morning News written by journalist and author Bill Minutaglio. The film, costing $5.5 million to make, follows the Woodroof, who was diagnosed with AIDS given only 30 days to live. The only drug available brought him close to death, forcing him to smuggle anti-viral medications from all over the world (unapproved by FDA and unavailable in the U.S) to survive. He forms a buyers club, providing paying members with these unsanctioned alternative treatments, resulting in the FDA and pharmaceutical companies seeking to end his illegal activities. More info: http://www.imdb.com/title/tt0790636/

Enough Said is a 2013 American romantic comedy directed and written by Nicole Holofcener. The film stars Julia Louis-Dreyfus, the James Gandolfini (in one of his final roles), Toni Collette, Catherine Keener, Ben Falcone, and Toby Huss. The 93 minute film’s plot center on a woman who befriends a woman and starts dating a man at the same time, only to find out that her two new acquaintances are former spouses. This leaves her in a dilemma about whether she should risk her new friendship and romantic partner if she reveals what she has learned about them from one another. More info: http://www.imdb.com/title/tt2390361/

Gravity is a science fiction thriller directed, co-written, co-produced and co-edited by Alfonso Curón… The film stars Sandra Bullock and George Clooney as astronauts involved in the mid-orbit destruction of a space shuttle and their attempt to return to Earth. More info: http://www.imdb.com/title/tt1454468/

Nebraska is a 2013 American comedy film starring Bruce Dern (father) and Will Forte (son). The 110 minute film (shot in black and white), directed by Alexander Payne, begins with Dern receiving a sweepstakes letter in the mail, who now thinks he is rich. He gets Forte to take a road trip, from Montana to Nebraska, to claim his prize. Along the way the two meet up with friends, relatives and acquaintances to whom the Dern ostensibly owes money. The $12 million budgeted film, shot in four states, tells the stories of family life in middle America. More info:
http://www.imdb.com/title/tt1821549/

Philomena is a 2013 British comedy-drama film directed by Stephen Frears. The 95 minute film is based on the book The Lost Child of Philomena Lee by Martin Sixsmith, which tells the true story of a birth mother, Philomena Lee’s 50-year-long search for her son, Michael, who she gave up for adoption. The book focuses more, as the title suggests, on the life her son had after his adoption. More info: http://www.imdb.com/title/tt2431286/

Saving Mr. Banks is a 2013 historical comedy-dram film directed by John Lee Handcock from a screenplay written by Kelly Marcel and Sue Smith. Centered on the development of the 1964 Walt Disney Studios film Mary Poppins, the film stars Emma Thompson as author P.L. Travers and Tom Hanks as filmmaker Walt Disney, with supporting roles from Paul Giamatti, Jason Schwartzman, Bradley Whitford, Ruth Wilson, and Colin Farrell. Taking its title from the father in Travers’ story, the film depicts the author’s fortnight- long briefing in 1961 Los Angeles as she is persuaded by Disney, in his attempts to obtain the screen rights to her novels. Produced by Walt Disney Pictures and BBC Films, the 125 minute film was shot entirely in the Southern California area, primarily at the Walt Disney Studios. More info: http://www.imdb.com/title/tt2140373/

The Butler is a 2013 American historical fiction drama film directed by Lee Daniels and written by Danny Strong. The 132 minute film is loosely based on the real life of Eugene Allen, the film stars Forest Whitaker as Cecil Gaines, an African-American who eyewitnesses notable events of the 20th century during his 34-year tenure serving as a White House butler. More info: http://www.imdb.com/title/tt1327773/

AARP Award Winners Announced in January

This year’s Top 10 Movies for Grownups offers a preview of AARP’s upcoming annual Movies for Grownups Awards, recognized as a bellwether for the Academy Awards, with standard categories including Best Actor, Actress and Director, in addition to a few unique offerings like “Best Grownup Love Story,” “Best Buddy Picture,” and “Best Time Capsule Movie.” The winners in all categories will be announced in early January, and will be featured online at http://www.aarp.org/movies. The entire list of award winners will also be featured in the February/March issue of AARP The Magazine, available February 1st.

Turning Off Older Moviegoers

Over the years, movie studios have turned their back on the nation’s aging baby boomers and seniors, targeting teenagers and young adults, In these films the plot is passed on the special interests of these younger demographic groups, such as coming of age, first love, rebellion, and conflict with parents, teen angst, and alienation. For decades, the cinema industry has chased after teens that are viewed to have more disposable income that is more money to spend on going to films.

AARP sends a powerful message to Hollywood studio executives that older moviegoers have different interests than their younger cohorts. They may well want to spend their discretionary income as the editors of AARP The Magazine note on “thoughtful films with timeless entertainment value.” If ignored, grownups may well spend their discretionary dollars on other leisure activities.

Movies for Grownups®, which now includes weekly reviews and an award-winning radio program, an annual film festival, and year-round coverage in AARP The Magazine and online, was started in 2002 by the editors of AARP The Magazine. Additional information can be found online at http://www.aarp.org/movies.

Herb Weiss, LRI ’12, is a Pawtucket-writer who covers aging, health care and medical issues. He can be reached at hweissri@aol.com.